Ukuhlolwa komsebenzi wePulmonary

Ukuhlolwa komsebenzi wePulmonary kuyiqembu lezivivinyo ezilinganisa ukuphefumula nokuthi amaphaphu asebenza kahle kangakanani.

ISpirometry silinganisa ukuhamba komoya. Ngokulinganisa ukuthi ukhipha umoya ongakanani, nokuthi ukhipha masinyane kangakanani, i-spirometry ingahlola izinhlobo eziningi zezifo zamaphaphu. Ekuhlolweni kwe-spirometry, ngenkathi uhleli, uphefumulela esikhaleni somlomo esixhunywe entweni ebizwa nge-spirometer. I-spirometer irekhoda inani nezinga lomoya ophefumula uphume uphume isikhathi esithile. Lapho umile, ezinye izinombolo zingahluka kancane.

Kwezinye izilinganiso zokuhlolwa, ungaphefumula ngokujwayelekile nangokuthula. Ezinye izivivinyo zidinga ukuhogela ngenkani noma ukukhipha umoya ngemuva kokuphefumula okukhulu. Kwesinye isikhathi, uzocelwa ukuthi uphefumule igesi ehlukile noma umuthi ukubona ukuthi uyishintsha kanjani imiphumela yakho yokuhlolwa.

Isilinganiso sevolumu yamaphaphu singenziwa ngezindlela ezimbili:

• Indlela enembile kunazo zonke ibizwa ngokuthi i-body plethysmography. Uhlala ebhokisini elicacile elingangeni moya elibukeka njengendlwana yocingo. Isazi sobuchwepheshe sikucela ukuthi uphefumulele ngaphakathi nangaphandle komlomo. Izinguquko ekucindezelweni ngaphakathi kwebhokisi zisiza ukunquma ivolumu yamaphaphu.
• Umthamo wamaphaphu ungalinganiswa futhi uma uphefumula i-nitrogen noma i-helium gas ngokusebenzisa ithubhu isikhathi esithile. Ukuhlungwa kwegesi egumbini elinamathiselwe kushubhu kukalwa ukulinganisa ivolumu yamaphaphu.

Ukukala umthamo wokusabalalisa, uphefumula igesi engenabungozi, ebizwa nge-tracer gas, isikhathi esifushane kakhulu, imvamisa ngokuphefumula okukodwa kuphela. Ukulinganiswa kwegesi emoyeni ophefumulela ngaphandle kuyalinganiswa. Umehluko enanini legesi udonsa futhi ukhiphe izinyathelo zokuthi igesi ihamba kanjani ngempumelelo isuka emaphashini iye egazini. Lokhu kuhlolwa kuvumela umhlinzeki wezokunakekelwa kwempilo ukuthi alinganise ukuthi amaphaphu ahambisa kanjani umoya-mpilo osuka emoyeni uye egazini.

Ungadli ukudla okunzima ngaphambi kokuhlolwa. Ungabhemi amahora amane kuya kwayisithupha ngaphambi kokuhlolwa. Uzothola imiyalo ethile uma udinga ukuyeka ukusebenzisa ama-bronchodilators noma eminye imithi ehogelwayo. Kungadingeka uphefumule emithini ngaphambi noma ngesikhathi sokuhlolwa.

Njengoba isivivinyo sifaka ukuphefumula ngenkani nokuphefumula okusheshayo, ungaba nokuphefumula okwesikhashana noma ube nekhanda elikhanyayo. Ungase futhi ube nokukhwehlela. Uphefumula ngomlomo obamba kahle futhi uzoba neziqeshana zamakhala. Uma u-claustrophobic, ingxenye yokuhlolwa etendeni elivaliwe ingazizwa ingakhululekile.

Landela imiyalo yokusebenzisa okokukhuluma kwe-spirometer. Uphawu olubi oluzungeze okokukhuluma lungadala imiphumela enganembi.

Ukuhlolwa komsebenzi wePulmonary kwenziwa ku:

• Thola izinhlobo ezithile zezifo zamaphaphu, njengesifuba somoya, i-bronchitis ne-emphysema
• Thola imbangela yokuphelelwa umoya
• Linganisa ukuthi ukuvezwa ngamakhemikhali emsebenzini kuthinta ukusebenza kwamaphaphu
• Hlola ukusebenza kwamaphaphu ngaphambi kokuba othile ahlinzwe
• Hlola umphumela wemithi
• Linganisa inqubekela phambili ekwelashweni kwezifo
• Linganisa impendulo ekwelashweni kwesifo semithambo yenhliziyo

Amanani ajwayelekile asuselwa eminyakeni yakho, ubude, ubuhlanga, nobulili. Imiphumela ejwayelekile ivezwa njengephesenti. Inani livame ukubhekwa njengokungajwayelekile uma cishe lingaphansi kuka-80% wenani lakho elibikezelwe.

Ububanzi bamanani ajwayelekile bungahluka kancane phakathi kwamalabhorethri ahlukene, ngokuya ngezindlela ezihluke kancane zokunquma amanani ajwayelekile. Khuluma nomhlinzeki wakho mayelana nencazelo yemiphumela yakho ethile yokuhlolwa.

Izilinganiso ezahlukahlukene ezingatholwa embikweni wakho ngemuva kokuhlolwa kokusebenza kwamaphaphu zifaka:

• Amandla we-diffusion to carbon monoxide (DLCO)
• Umthamo wokugcina ophefumulayo (ERV)
• Amandla okuphoqelelwa abalulekile (FVC)
• Ivolumu yokuphoqa ephoqelelwe ngomzuzwana owodwa (FEV1)
• Ukugeleza okuphoqelelwe kokuphelelwa yisikhathi 25% kuya ku-75% (FEF25-75)
• Umthamo wensalela osebenzayo (i-FRC)
• Ukupholisa umoya okuphezulu (MVV)
• Ivolumu eyinsalela (RV)
• Ukugeleza okuphezulu kokuphefumula (PEF)
• Umthamo wokubaluleka okuhamba kancane (SVC)
• Ingqikithi yamaphaphu (TLC)

Imiphumela engajwayelekile isho ukuthi ungaba nesifo sesifuba noma samaphaphu.

Ezinye izifo zamaphaphu (njenge-emphysema, i-asthma, i-bronchitis engamahlalakhona, kanye nezifo) zingenza amaphaphu abe nomoya omningi futhi athathe isikhathi eside ukuwakhipha. Lezi zifo zamaphaphu zibizwa ngokuthi ukuphazamiseka kwamaphaphu.

Ezinye izifo zamaphaphu zenza amaphaphu abe nezibazi futhi abe mancane ukuze aqukethe umoya omncane kakhulu futhi ahlwempu ngokudlulisela umoya-mpilo egazini. Izibonelo zalezi zinhlobo zezifo zifaka:

• Ukhuluphele ngokweqile
• I-pulmonary fibrosis (ukusika noma ukuqina kwezicubu zamaphaphu)
• I-Sarcoidosis ne-scleroderma

Ubuthakathaka bemisipha bungadala nemiphumela yokuhlolwa engajwayelekile, noma ngabe amaphaphu ejwayelekile, okungukuthi, afana nezifo ezidala amaphaphu amancane.

Kukhona ingozi encane yokuwa kwamaphaphu (pneumothorax) kubantu abanesifo esithile samaphaphu. Ukuhlolwa akufanele kunikezwe umuntu ohlangabezane nokuhlaselwa yinhliziyo muva nje, onezinye izinhlobo ezithile zesifo senhliziyo, noma osanda kuba namaphaphu awa nje.

Ama-PFTs; I-Spirometry; I-Spirogram; Ukuhlolwa kwemisebenzi yamaphaphu; Ivolumu yamaphaphu; I-Plethysmography

• I-Spirometry
• Ukuhlolwa komeshi

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UPutnam JB. Amaphaphu, udonga lwesifuba, i-pleura, ne-mediastinum. Ku: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. ISabiston Incwadi Yokuhlinzwa: Isisekelo Sebhayoloji Sokuzijwayeza Kwamanje Kokuhlinzwa. Umhla ka-20. IPhiladelphia, PA: Elsevier; 2017: isahluko 57.

IScanlon PD. Umsebenzi wokuphefumula: izindlela nokuhlola. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 79.